Correlation Between Monocyte Subsets,Monocyte/High-Density Lipoprotein Cholesterol Ratio And Short-Term Prognosis In Patients With STEMI

Purpose:1.To investigate the changes of Monocyte subsets after STEMI and the relationship between Monocyte subsets and Major adverse cardiovascular events in patients with STEMI.2.To explore the relationship between Monocyte/High-density lipoprotein cholesterol ratio(MHR)and Major adverse cardiovascular events in patients with STEMI.3.To explore the value of Monocyte subsets and(MHR)in predicting Major adverse cardiovascular events in patients with STEMI.Methods:A total of 30 patients with STEMI who hospitalized in the department of Cardiovascular Medicine,Central Theater General Command Hospital from August 2020 to December 2020 were included,and all of them received selective percutaneous coronary intervention(Coronary stent implantation).According to whether or not had Major adverse cardiac events(MACE)occurred during hospitalization,they were divided into the MACE group(21 cases)and the non-MACE group(9 cases).Patients without coronary atherosclerotic heart disease were selected as the control group(10 cases).(1)The distribution difference of Monocyte subsets between MACE group,non-MACE group and control group was compared.(2)The MHR was compared between the MACE group and the non-MACE group.Analyze the correlation between Monocyte subsets and MHR.(3)ROC curve was used to analyze the predictive efficiency of MHR,monocyte subsets and their combination on MACE.Results:1.There were significant differences in CD14++CD16+between the MACE group and the non-MACE group(10.3±4.7vs.5.8±2.8,1P=0.003),while there was no significant difference between CD14++CD16-and CD14+CD16++(1P=0.45;1P=0.43);CD14++CD16+increased in the MACE group compared with the control group,and the difference was significant(10.3±4.7vs.5.4±1.6,2P=0.007),while there was no significant difference between CD14++CD16-and CD14+CD16++(2P=0.38;2P=0.30).Monocyte subsets had no different between non-MACE and control groups(3P=0.97;3P=0.68;3P=0.90).CD14++CD16+was an independent risk factor for MACE(OR:1.83,95%CI:1.07～3.13;P=0.03).2.The MHR value of MACE group was higher than that of non-MACE group,and the difference was significant(0.92±0.45vs.0.62±0.30,1P=0.04).However,there were no differences in the Monocyte count and HDL cholesterol concentration between the two groups.The MHR of MACE group,non-MACE group were significantly higher than those in the control group(2P=0.01;3P<0.001).CD14++CD16+was positively correlated with MHR(r=0.40,P=0.01),while CD14++CD16-and CD 14+CD16++had no correlation with MHR(P=0.94;P=0.17).3.The area under the ROC curve(AUC)of MACE predicted by MHR was 0.762(95%CI:0.57～0.90),the Youden index(sensitivity+specificity-1)was 0.56,the cutoff value was 0.64,the sensitivity was 88.9%,and the specificity was 66.7%.The area under the ROC curve(AUC)of CD 14++CD16+was 0.815(95%CI:0.24~0.67),the Youden index(sensitivity+specificity-1)was 0.51,and the cut-off value was 5.48,the sensitivity was 88.9%,and the specificity was 61.9%.The area under the ROC curve of CD14++CD 1 6+(0.815)was larger than that of MHR(0.762),but there was no significant difference between them(P=0.72).The combination of MHR and CD144+CD16+ can improve the efficiency of predicting the occurrence of in-hospital MACE in patients with STEMI..The area under the ROC curve(AUC)is 0.862(95%CI:0.68～0.96),the Jordan index(sensitivity+specificity-1)is 0.68,the sensitivity is 77.8%,and the specificity is 90.5%.Conclusion:1.The increase of CD14++CD16+was an independent predictor of in-hospital MACE after STEMI,with an optimal cut-off value of 5.48.2.MHR was an predictor of in-hospital MACE after STEMI,with an optimal cutoff value of 0.64.3.CD14++CDI16+was positively correlated with MHR.4.The combination of CD14++CD16+and MHR can significantly improve the predictive efficiency of in-hospital MACE in patients with STEMI.